Duration of human chorionic gonadotropin surveillance for partial hydatidiform moles

Am J Obstet Gynecol. 2005 May;192(5):1362-4. doi: 10.1016/j.ajog.2004.12.080.

Abstract

Objective: Partial hydatidiform moles infrequently progress to gestational trophoblastic neoplasia. The purpose of this study was to determine the optimal duration of human chorionic gonadotropin surveillance.

Study design: We retrospectively reviewed the clinical follow-up of all women who were diagnosed with partial hydatidiform mole at our institution from 1983 to 2003.

Results: One hundred sixty-three patients were identified with a median age of 23 years (range, 14-42 years). Seventy-four patients (45%) attained undetectable levels of human chorionic gonadotropin; none of the patients had gestational trophoblastic neoplasia. Forty patients completed the 6 months of recommended follow-up; 6 patients conceived during surveillance, and 28 patients did not return for any further office visits 1 to 5 months after achieving remission. Eighty-three patients (51%) were lost to follow-up before normalization of human chorionic gonadotropin. Six women (4%) had stage I gestational trophoblastic neoplasia during surveillance.

Conclusion: Our results support the suggestion that a single undetectable human chorionic gonadotropin level after evacuation is sufficient follow-up to ensure remission in patients with partial hydatidiform moles.

MeSH terms

  • Adolescent
  • Adult
  • Chorionic Gonadotropin / blood*
  • Female
  • Gestational Trophoblastic Disease / blood
  • Gestational Trophoblastic Disease / diagnosis
  • Gestational Trophoblastic Disease / epidemiology
  • Gestational Trophoblastic Disease / pathology
  • Humans
  • Hydatidiform Mole / blood*
  • Hydatidiform Mole / surgery
  • Incidence
  • Neoplasm Staging
  • Population Surveillance*
  • Postoperative Period
  • Pregnancy
  • Retrospective Studies
  • Time Factors

Substances

  • Chorionic Gonadotropin